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The aim was to compare reproductive outcomes of Nelore heifers submitted to timed AI (TAI) protocols, with 7 or 9 d of permanence of the intravaginal progesterone (P4) device and different times of prostaglandin F2α (PGF) administration, for first (n = 935) and second (n = 530) services. On Day -24, heifers without corpus luteum (CL) underwent a protocol for induction of ovulation. On Day 0, heifers received a P4 device (0.5 g) and 1.5 mg estradiol (E2) benzoate. In order for the TAI to be carried out on the same day, these treatments were performed 2 d later on the heifers treated with the 7-d protocol. Additionally, heifers received 0.5 mg PGF at different times, resulting in four experimental groups: 9dP4-PGFd9 (n = 365); 9dP4-PGFd7 (n = 369); 9dP4-PGFd0&9 (n = 364); 7dP4-PGFd0&7 (n = 367). These nomenclatures indicate for how many d the P4 device was kept and the specific day on which PGF was given. At P4 removal, all heifers received 0.5 mg E2 cypionate and 200 IU eCG, and TAI was performed 2 d later. Effects were considered significant when P ≤ 0.05 (superscript letters a,b ) whereas a tendency was assumed when 0.05 < P ≤ 0.10. Groups 9dP4-PGFd0&9 and 7dP4-PGFd0&7 had lower percentage of heifers with CL at P4 removal. The diameter (mm) of the dominant follicle (DF) was affected by treatment at P4 removal (9dP4-PGFd9: 11.3 ± 0.3 b ; 9dP4-PGFd7: 11.8 ± 0.2 ab ; 9dP4-PGFd0&9: 12.6 ± 0.2 a ; 7dP4-PGFd0&7: 10.8 ± 0.2 c ) and at TAI (9dP4-PGFd9: 12.7 ± 0.3 ab ; 9dP4-PGFd7: 13.2 ± 0.2 a ; 9dP4-PGFd0&9: 13.4 ± 0.2 a ; 7dP4-PGFd0&7: 12.4 ± 0.3 b ). Expression of estrus (%) was affected by treatment (9dP4-PGFd9: 89.6 a ; 9dP4-PGFd7: 93.5 a ; 9dP4-PGFd0&9: 88.2 ab ; 7dP4-PGFd0&7: 85.6 b ). There were no differences among treatments for P/AI on Day 40 (30-35 d post AI), final P/AI (between Day 70 and parturition) and pregnancy loss (between Day 40 and final P/AI). When the permanence of the P4 device was compared, regardless of PGF treatments, 9-d protocols resulted in greater DF diameter at P4 removal and at TAI, and greater expression of estrus (90.4 vs. 85.6%) than the 7-d protocol. Despite that, the 7-d protocol resulted in greater P/AI on Day 40 (55.3 vs. 49.1%). In addition, there was an interaction between protocol duration and body weight, in which heavier heifers (≥ 307 kg) had greater P/AI when treated with the 7-d protocol, in comparison to 9-d. In conclusion, longer TAI protocols (9 d of P4 device duration) resulted in greater DF diameter and expression of estrus. However, the shorter TAI protocol (7 d of P4 device duration) produced greater P/AI on Day 40, particularly in heavier heifers. Within 9-d protocols, the additional dose of PGF on Day 0 or the anticipation of the PGF to Day 7 did not influence fertility., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The larynx is in the lower respiratory tract and has the function of protecting the airways, controlling, and modulating breathing, assisting the circulatory system, and vocalizing. This study aims to describe the anatomy and histology of the skeleton of the larynx and trachea of the species Chelonia mydas, Caiman yacare and Caiman latirostris. The study was conducted at the Federal University of Espírito Santo (UFES), using nine specimens of Ch. mydas, 20 of Ca. yacare and four of Ca. latirostris. Samples of the larynx and trachea were collected, fixed, and sent for dissection of the structures and subsequent macroscopic analysis. For histology, samples were processed by the routine paraffin embedding method and stained with hematoxylin-eosin and Verhoeff. For the three species, two arytenoid cartilages, a cricoid cartilage, a hyoid apparatus composed of a base and two horns were found. In Ch. mydas, two structures called thyroid wings were observed, not found in crocodilians. The trachea of crocodilians presented incomplete tracheal rings and musculature, while the trachea of Ch. mydas presented complete tracheal rings. Histologically, the entire cartilaginous skeleton of the larynx of the three species, as well as the tracheal rings, are constituted by hyaline cartilage.

The increasing global importance of pink peppertree (Schinus terebinthifolia, Anacardiaceae) as a high-value commercial crop and its potential for expansion in production demand appropriate management due to uncertainties regarding its sexual system. This study focused on evaluating the morphology of sterile and fertile floral whorls, as well as analyzing the sexual system of pink pepper in two populations in northeastern Brazil. The results revealed no significant differences in the morphological characteristics of the flowers between the studied areas, suggesting that the species possesses notable adaptability to environmental conditions. However, a significant difference in the proportion of staminate individuals was observed in both areas, representing over 88% and 72%, respectively. A correlation was observed between the size of the stamens and the presence of apparently atrophied pistils (r=0.275; df=178; p<0.001), along with the occurrence of fruits in these hermaphroditic plants. In this context, the species should be considered gynodioecious due to the presence of plants with hermaphroditic flowers and plants with pistillate flowers. However, further research is essential to elucidate the role of pollinators, especially bees and wasps, and to better understand the fruiting process in hermaphroditic flowers. These insights have the potential to significantly enhance management aiming for efficient fruit production, promoting its economic and ecological relevance.

The objective of the current study was to carry out a survey of the main anatomopathological alterations in raising quails and evaluate possible interference of these in the bone tissue. To obtain the data, 23 quails were collected from farm in the central Serrana region of Espírito Santo. Necropsies with macroscopic descriptions, microbiological, coproparasitological, radiographic and histomorphometric tests were carried out. It was done data descriptive analysis and average comparision using Student T test. It was found that they presented lesions predominantly in the digestive system, followed by urinary and reproductive, and muscular system, were the altered color of the liver (47%) was the most frequent lesion. In the parasitological exams, it was found oocysts of Eimeira sp. (39.13%). In the microbiological exams, it was detected predominantly Escherichia coli (83%). Moderate osteopenia in quails, but the percentage of trabecular bone on bones was similar between healthy and diseased quails, without bone changes in histology. Microscopically, it was observed lung congestion as predominant lesion. It is concluded that there was predominance of alterations in the digestive system and mild parasitic infection; and although there was moderate level of osteopenia, there wasn't bone change as a result of the observed infections.

Nitrogen is one of the essential nutrients for the production of agricultural crops, participating in a complex interaction among soil, plant and the atmosphere. Therefore, its monitoring is important both economically and environmentally. The aim of this work was to estimate the leaf nitrogen contents in sugarcane from hyperspectral reflectance data during different vegetative stages of the plant. The assessments were performed from an experiment designed in completely randomized blocks, with increasing nitrogen doses (0, 60, 120 and 180 kg ha -1 ). The acquisition of the spectral data occurred at different stages of crop development (67, 99, 144, 164, 200, 228, 255 and 313 days after cutting; DAC). In the laboratory, the hyperspectral responses of the leaves and the Leaf Nitrogen Contents (LNC) were obtained. The hyperspectral data and the LNC values were used to generate spectral models employing the technique of Partial Least Squares Regression (PLSR) Analysis, also with the calculation of the spectral bands of greatest relevance, by the Variable Importance in Projection (VIP). In general, the increase in LNC promoted a smaller reflectance in all wavelengths in the visible (400-680 nm). Acceptable models were obtained (R 2  > 0.70 and RMSE <1.41 g kg -1 ), the most robust of which were those generated from spectra in the visible (400-680 nm) and red-edge (680-750 nm), with values of R 2  > 0.81 and RMSE <1.24 g kg -1 . An independent validation, leave-one-date-out cross validation (LOOCV), was performed using data from other collections, which confirmed the robustness and the possibility of LNC prediction in new data sets, derived, for instance, from samplings subsequent to the period of study., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

The aim of this study was to identify Cryptosporidium species found in cattle and sheep in Paraná, southern region of Brazil. Individual fecal samples from 458 bovines and 101 sheep were submitted for molecular analysis by PCR and nested PCR using specific primers for sequences of the 18S ribosomal unit (rRNA). Positive samples were analyzed using restriction fragment length polymorphism (RFLP), followed by genetic sequencing for species confirmation. The occurrence of Cryptosporidium was 11.27% (63/559). The highest occurrence was detected in lambs (12/59, 20.33%). From the 63 positive samples, it was possible to identify the species in 58 of them by RFLP and genetic sequencing. Five species of Cryptosporidium were identified: Cryptosporidium andersoni, Cryptosporidium bovis, Cryptosporidium ryanae, Cryptosporidium xiaoi, and Cryptosporidium parvum. The most prevalent species was C. andersoni (41.38%) and the least predominant was C. parvum (10.34%). The most abundant species of Cryptosporidium in dairy calves were C. andersoni (11/25) and C. ryanae (6/25). Of the 17 positive sheep, nine (52.94%) were infected with C. andersoni. This finding is the first report on the occurrence of C. andersoni in naturally infected sheep in Brazil and the first observation of a high absolute occurrence of this Cryptosporidium species in sheep.

The objective of this study was to evaluate the effect of different levels of concentrate supplementation on carcass characteristics of heifers finished on Tifton 85 pasture. Thirty-two cross-breed heifers (Charolais and Nellore) on average aged 25.51 months and weighing 298 kg were used in a completely randomized experiment. The animals were distributed uniformly to receive four different levels of concentrates based on the body weight: 0.0; 0.4; 0.8 and 1.2%. Animals were slaughtered at 29 months of age. There was increasing linear effect of levels energy supplementation on: slaughter weight, hot and cold carcass weights,hot and cold dressing percentage, thigh thickness, carcass compactness, and L* and b* color values. It was observed quadratic effect of levels of energy supplementation on the percentage of fat in the carcass. Different levels of energy supplementation did not modify the accumulation of vital organs and visceral fat or the sensory attributes of the meat. Higher levels of energy supplementation promote increases in carcass traits of heifers when finished on Tifton 85 pasture.

Objective: to describe the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo, Brazil, 2007-2018., Methods: this was a descriptive study of cases of abortion, fetal and non-fetal deaths due to congenital syphilis reported on the Notifiable Health Conditions Information System (Sistema de Informação de Agravos de Notificação - SINAN), and those of congenital syphilis registered in any line in the Death Certificate, on the Mortality Information System (Sistema de Informações sobre Mortalidade - SIM), by means of probabilistic and deterministic linkage., Results: of the 27,713 cases of congenital syphilis reported, 1,320 progressed to death (871 fetal deaths, 449 infant deaths) and were matched to the SIM; 355 deaths (259 fetal deaths, 96 infant deaths) were not included on SINAN; there was an increase in unfavorable outcomes,11.4% for infant deaths due to congenital syphilis, 3.0% for fetal deaths and 1.9% for abortions., Conclusion: the use of different relationship techniques proved to be adequate to identify the frequency of underreporting of unfavorable outcomes of congenital syphilis in the state of São Paulo.

The introduction of the special issue "Disease Reservoirs: Anthropological and Historical Approaches" sets out the origins and trajectories of disease reservoir frameworks. First, it charts the emergence and elaborations of the reservoirs concept within and across early 20th-century colonial contexts, emphasising its configuration within imperial projects that sought to identify, map and control spaces of contagion among humans, animals, and pathogens. Following this, it traces the position the reservoir framework assumed within post-colonial practices and imaginaries of global health, with particular reference to the emerging infectious disease paradigm. The introduction shows that, in contemporary usages, while the concept continues to frame animals, humans and their bodies as containers of previously identified pathogens, it also emphasises the imperative of anticipating as-of-yet unknown diseases, harboured in the bodies of certain animals, through networks and techniques of surveillance. Consequently, the introduction argues that the notion of disease reservoirs remains intimately intertwined with concerns over the classification, organization, and management of peoples, pathogens, animals, and space. Finally, the introduction outlines the seven papers that form this special issue, stressing how they dialogue, complement, and challenge previous historical and anthropological approaches to disease reservoirs, with an eye to opening up new avenues for cross-disciplinary exploration.

Objective: We report a case of biopsy-proven giant cell arteritis after an initial presentation of area postrema syndrome., Methods: A 65-year-old man was evaluated using MRI, temporal artery biopsy, and ultrasound., Results: The patient presented with refractory nausea, vomiting, and hiccups that caused weight loss without any other neurologic or clinical symptoms. His MRI scan 15 days later revealed a hyperintense sign on the area postrema with no abnormal diffusion or contrast enhancement, compatible with isolated area postrema syndrome. An extensive workup for inflammation and other etiologies including neuromyelitis optica spectrum disorder (NMOSD), myelin oligodendrocyte glycoprotein antibody disorder, and multiple sclerosis (MS) showed negative results. The patient responded to treatment with methylprednisolone. Two months after the initial clinical manifestation, the patient developed fatigue, headache, and scalp tenderness. He was diagnosed with giant cell arteritis after ultrasonography and biopsy were performed. He responded well to oral glucocorticoids and had only 1 relapse during tapering. He has not had arteritic ischemic optic neuropathy or any new episodes of area postrema syndrome., Discussion: This case demonstrates the importance of expanding the differential diagnosis in patients with area postrema syndrome and no other signs of NMOSD., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Invertebrates are harmed by pollution of their habitats. Litter-dwelling sedentary scorpions, such as Tityus pusillus, studied here, may be good models for examining the genotoxic effects of xenobiotics in soil. Thirty specimens were collected from five sites in Northeast Brazil with different levels of human disturbance, as well as a laboratory group. The comet assay was performed on hemolymph cell samples. Damage Index (DI) and Damage Frequency (DF%) were measured. Much higher genotoxicity was observed in animals collected in an area with human interference and solid waste, compared to those obtained in more pristine areas or the laboratory. T. pusillus may be a useful model for environmental genotoxicity assays., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objectives: to construct and validate an instrument to assess the knowledge, attitudes, and practices related to pressure injury prevention among caregivers of institutionalized older people., Methods: this is a three-stage methodological study that consisted of instrument construction, analysis by experts, and semantic and appearance analysis, with 78 participants, observing the validation process steps for psychometric instruments in the criteria of clarity and relevance., Results: in the Delphi I round, the validity index of the general content in the clarity criterion was 0.66, in relevance 0.85, and the Kappa value was >0.76. In Delphi II, clarity was 0.95, relevance 1.00, and the Kappa value was >0.97., Conclusions: this is a valid instrument in terms of content and appearance, which allows further analysis of its reliability for the measurement of the constructs for which it is intended. Therefore, it can be considered a tool for care management in pressure injury prevention.

Between 2015 and 2019, Brazil recorded the two most serious disasters involving mining dams of the 21st century. The purpose of this article is to offer an understanding of these disasters as systemic risks. They involve from global and national processes related to social determinants that materialize in a complex system of dams distributed throughout the country with their intrinsic risks. When they occur, result in a set of impacts with potential damage and immediate effects combined with secondary and tertiary impacts that can trigger chain reactions, which promote risk factors of heterogeneous and complex occurrence. Approaching these events from the point of view of systemic risk allows for a broader understanding of both the singularity of each of these disasters and their multiple exposure, risk and disease processes, as well as the structural characteristics in which social, political processes and dynamics and economic factors reproduce in multiple territories a common pattern of disasters and their effects. We conclude that the promotion of population health and sustainable territories should guide the organization of production processes and not the opposite, with the externalization of human, environmental and social costs of mining and its disasters.

Eretmochelys imbricata (hawksbill turtle) is classified as a critically endangered species at world level; in Brazil, it is listed among the threatened species. Spirorchiids are parasites of the circulatory system of chelonians which may cause serious lesions in the various tissues of the host due to deposition of eggs in the bloodstream. In this context, the aim of the present study was to describe the pathology caused by spirorchiid eggs in E. imbricata from the Brazilian over a five year period. A total of 29 animals were analyzed, of which nine (31%) presented lesions associated to spirorchiids eggs. The lesions were: granulomatous enteritis in six (66.66%), granulomatous splenitis in five (55.55%), granulomatous hepatitis in three (33.33%), granulomatous pneumonia in three (33.33%), granulomatous pancreatitis in two (22.22%), and granulomatous adrenalitis in one specimen (11.11%). Concluded the main lesion in Eretmochelys imbricata was giant-cell granulomatous inflammatory reaction to the parasite's eggs. Animals exhibiting poor physical health were more susceptible to presenting such lesions.

Few studies have assessed frequency of maltreatment and other factors associated with maltreatment of deaf and hard of hearing children. The present study's objective was to verify the frequency of physical and psychological maltreatment and associated factors experienced by DHH children. DHH children from low-income families in Maceió, Brazil, were studied (N = 265). The Parent-Child Conflict Tactics Scales (Straus et al., 1998) were used to identify nonviolent discipline, psychological aggression, and physical assault (minor, severe, very severe). The study found that 221 children (83.4%) experienced physical assault; 238 (89.8%) experienced psychological aggression. Both physical and psychological aggression was reported for 94.3%. Most mothers (98.1%) reported using nonviolent discipline. Maltreatment was associated with male children, mothers' job dissatisfaction, religiously nonobservant families, and children born of unintended pregnancy. In conclusion, high frequencies of physical and psychological maltreatment of DHH children of low-income families were found.

Objectives: There is a critical need to monitor the development of children around the world, and in Brazil, this need is substantial since there is a paucity of assessment tools. This study aimed to describe the design and provide evidence of reliability and validity for the short version of the Dimensional Inventory for Child Development Assessment (IDADI-short)., Methods: A sample of 1,865 biological mothers of children aged 4-72 months (M = 34.8, SD = 20.20) completed the IDADI to assess Cognitive, socio-emotional, Expressive, and Receptive Language and Communication, Fine and Gross Motor, and Adaptive Behavior development. The psychometric properties of a total of 118 subscales of IDADI were obtained and the IDADI-short age-specific scores were correlated with the original inventory, and criteria variables such as neurodevelopment diagnosis, socioeconomic status, and sex., Results: Item Response Theory analysis, Cronbach's Alpha, and McDonald's Omega indicated excellent internal consistency and optimal participant discrimination after minor alterations. IDADI-short scores were strongly associated with the original inventory, with high sensibility and specificity precision for developmental delays. Significant associations with relevant criteria variables were also observed., Conclusion: Findings support the use of IDADI-short as a parental measure of young children's development., (Copyright © 2021 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

The aim of this study was to evaluate the progesterone (P4) release profile provided by eight commercial intravaginal P4 devices, as well as the effect of circulating P4 concentrations produced exclusively by these devices on the development of the dominant follicle (DF) in non-lactating multiparous Holstein cows. All cows were submitted to the same experimental design starting with the insertion of a reused P4 device (2 g - original P4 load) for 7 d, followed by two treatments of cloprostenol sodium (PGF; 0.482 mg), 24 h apart, 6 and 7 d after device insertion. Just before device removal, a Norgestomet ear implant was inserted and, 2 d later (Day 0), simultaneously to Norgestomet withdrawal, cows received one of the tested intravaginal devices and 2 mg of estradiol benzoate (EB) im. In Exp.1 (n = 22; three replicates), cows were randomized to receive: CIDR (1.38 g); PRID-Delta (1.55 g); Prociclar (0.75 g); or Repro sync (2 g). In Exp. 2 (n = 29; four replicates), cows were randomized to receive: Cue-Mate (1.56 g); DIB 0.5 (0.5 g); DIB (1 g); PRID-Delta (1.55 g); or Sincrogest (1 g). Blood samples were collected before P4 device insertion (Day 0), 12 h later and daily over 15 d (1 d after P4 device removal). Ultrasound examinations were performed to evaluate growth of the DF on Days 0, 7, 8, 9, and 10. Results are presented as mean ± SEM and differences were considered when P ≤ 0.05. Overall, the circulating P4 profile and mean circulating P4 over 10 d differed among treatments. However, no effects were observed on the DF diameter and follicular growth rate from Day 7-10 after P4 device insertion. In Exp. 2, devices that provided higher circulating P4 concentrations were associated to a slower DF growth during the treatment period. Finally, this study provided a better understanding of the P4 release profile produced by intravaginal P4 devices as well as their effect on circulating P4 concentrations and DF development in non-lactating Holstein cows., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objective: To analyze how syphilis detection rates evolved from 2011 to 2017 according to sex, age and place of residence in the state of São Paulo., Methods: A historical series was organized with data from the Notification Disease Information System. The acquired syphilis detection rates (ASDR) per 100,000 inhabitants and the acquired syphilis detection rates including pregnant women with syphilis (PASDR) per 100,000 inhabitants were described. For a trend analysis of the rates in the studied period, the Poisson Jointpoint (inflection point) model was performed, and the annual percentage change (APC) per segment and the average annual percentage change (AAPC) were estimated, with respective 95% confidence intervals (95%CI)., Results: A total of 205,424 cases of acquired syphilis and syphilis in pregnant women in the period were reported. The ASDR per 100,000 inhabitants ranged from 26.0 to 84.6 between 2011 and 2017 and the PASDR per 100,000 inhabitants ranged from 33.7 to 108.9; the trend was increasing in both, and an inflection point was identified dividing the ASDR and PASDR curve into two periods: 2011 to 2013 and 2013 to 2017: the AAPC found for ASDR was 21.0% (95%CI 15.5 ‒ 26.4) and the PASDR was 21.2% (95%CI 16.4 ‒ 26.1), in the age groups up to 24 years old, there was a significant growth in both sexes. A heterogeneity in the evolution of rates by region of the state was observed between 2011 and 2017., Conclusions: The increasing trend in acquired syphilis detection rates can be attributed to better adherence to notification and disproportionate involvement of young people.

Objectives: to validate nursing interventions for the diagnosis Risk for Impaired Skin Integrity in adult and aged hospitalized patients., Methods: descriptive, quantitative study, using the content validity of interventions done by 14 specialist nurses., Results: the specialist nurses had worked in the area for more than five years. Four (28.5%) used NANDA-I and CIPE®, three (21.4%) used NANDA-I, NIC and CIPE®, three (21.4%) used NANDA-I, NIC, NOC and CIPE® and four (28.5%) were currently working only with CIPE®. The validation analyzed 32 NIC interventions, of which 11 were priority and 21 were suggested. Of the priority interventions, five belonged to the Physiological/Complex domain, five to the Physiological/Basic domain and one to the Safety Domain., Final Considerations: nursing interventions are essential for planning and support good practices in teaching, research and care.

The transgender population encounters several barriers in entering the labor market, whichfurther impacts their health. In this cross-sectional study, the factors associated with their insertion in the formal job market were analyzed. Participants were recruited in seven municipalities of the state of São Paulo between 2014 and 2015. Logistic regression was used to estimate the odds ratios (OR) of the association between formal insertion and selected characteristics. We included 672 individuals, of which 82.3% were working, 13.1% were not employed, and 4.6% were not in the labor market. Among those working, only 16.7% were in the formal labor market. Factors independently associated with formal employment were: being atrans man, having 12 years or more of education, being under follow-up for gender transition procedures in the healthcare services, having private health insurance, and never having been arrested. Our results highlightpart of the obstacles the transgender population has toovercome to enter the labor market, and point to the need for public policies specifically designed for the transgender population aiming to reduce school dropout and expand access to comprehensive health care, thereby reducing theirvulnerability.

Introduction: Care continuum models have supported recent strategies against sexually transmitted diseases, such as HIV and Hepatitis C (HCV)., Methods: HIV, HCV, and congenital syphilis care continuum models were developed, including all stages of care, from promotion/prevention to clinical control/cure. The models supported the intervention QualiRede, developed by a University-Brazilian National Health System (SUS) partnership focused on managers and other professionals from six priority health regions in São Paulo and Santa Catarina. Indicators were selected for each stage of the care continuum from the SUS information systems and from the Qualiaids and QualiAB facility's process evaluation questionnaires. The indicators acted as the technical basis of two workshops with professionals and managers in each region: the first one to identify problems and to create a Regional Technical Group; and the second one to design action plans for improving regional performance., Results: The indicators are available at www.qualirede.org. The workshops took place in the regions of Alto Tietê, Baixada Santista, Grande ABC, and Registro (São Paulo) and of Foz do Rio Itajaí (Santa Catarina), which resulted in regional action plans in São Paulo, but not in Santa Catarina. A lack of awareness was observed regarding the new HIV and HCV protocols, as well as an incipient use of indicators in routine practices., Conclusion: Improving the performance of the care continuum requires appropriation of performance indicators and coordination of care flows at local, regional, and state levels of management.

The most common neurological impairments related to schistosomiasis involve the lower portions of the medulla and the cauda equina. A 22-year-old woman, with no history, signs, or symptoms of hepatointestinal schistosomiasis, presented with lumbar pain associated with acute paresthesia and paresis of the right lower limb. Spinal schistosomiasis was suspected based on the disease progression and radiological findings, and the diagnosis was confirmed after cerebrospinal fluid analysis. The authors emphasize this pathology as important as a differential diagnosis in similar clinical scenarios, especially in endemic areas, because both early diagnosis and treatment are essential to avoid permanent sequelae.

Objective: to evaluate the completeness of perinatal death investigation sheets, stratified by age components., Method: descriptive study carried out in Recife, PE, in 2014. Among 308 perinatal deaths, 46 were excluded from this study due to association with congenital malformations, and 7 due to missing investigation sheets. Analysis included 255 deaths (160 fetal deaths, and 95 preterm neonatal deaths). The degree of completeness of 98 variables was calculated. They were aggregated into six blocks: identification, prenatal care, birth care, family characteristics, occurrence of death and conclusions and recommendations., Results: the median rate of completeness for perinatal death investigation sheets was 85.7% (82.8% for records of fetal deaths and 89.5% for records of preterm neonatal deaths). The best-filled information block was "identification" (96.1%), as well as its components: fetal (94.7%) and preterm neonatal (97.9%). The worst was "prenatal care" (69.8%), along with its components: fetal (73.8%) and preterm neonatal (67.4%)., Conclusion: investigation sheets had good completeness; there were differences between variables and components of perinatal death.

Maternal alcoholism can induce serious injuries in embryonic and fetal development. The metabolism of alcohol increases the production of free radicals and acetaldehyde, molecules capable of reacting with DNA, impairing organogenesis. Melatonin is a powerful antioxidant that can act as a protective agent against DNA damage caused by genotoxic agents, such as ethanol. This study evaluated the protective effect of exogenous melatonin in rats and their offspring on the genotoxic response induced by chronic alcohol consumption during pregnancy. Twenty-five pregnant rats were divided into the following groups: NC - Negative control; ET - Rats receiving ethanol (3 g/kg/day); ET+10 M - Rats receiving ethanol (3 g/kg/day) and melatonin (10 mg/kg/day); ET+15 M - Rats receiving ethanol (3 g/kg/day) and melatonin (15 mg/kg/day); PC - Positive control (40 mg/kg cyclophosphamide). The dams and 10 pups (five males and five females) from each group were anesthetized to collect blood and liver from the dams and blood, liver and brain of neonates to evaluate the frequency of DNA damage by the comet assay. Blood was also used for the micronucleus test. The results demonstrated a significant increase in DNA damage in the blood and liver cells of dams receiving ethanol and their offspring as well as in the brain of these neonates. Treatments with melatonin (10 and 15 mg/kg/day) significantly reduced the genotoxicity caused by ethanol in the blood of dams and neonates (males and females), liver of dams and male offsprings, and in the brain of female offsprings. It was shown that only the female offspring exposed to maternal alcohol consumption showed a higher frequency of micronuclei in polychromatic erythrocytes. Consequently, exogenous melatonin may be a promising therapeutic agent against genotoxic damage induced by alcohol; however, further studies are needed to confirm these benefits., (Copyright © 2018 Elsevier B.V. All rights reserved.)

The aim of this study was to assess dietary intake, breastfeeding history, weight at birth and current weight in children and adolescents with Down syndrome (DS). Therefore, a cross-sectional, controlled study with 19 DS participants and 19 controls without DS matched by gender and age was performed. Except for vitamin D, a lower or the same frequency of insufficient intake in other micronutrients was noted in participants compared with controls. The DS group had a reduced exclusive breastfeeding duration and increased carbohydrate and caloric intake. The consumption of micronutrients in both groups reinforced the current trend of excessive sodium consumption and insufficient intake of calcium, some B complex vitamins and water by children and adolescents.

The 1988 Constitution represents an important achievement in terms of rights and an important pact sealed around a long-term strategy for the nation's future based on a social development model oriented towards reducing the risk of disease and injuries and an ecologically balanced environment. These achievements manifested themselves in policies, institutionalization and the creation of spaces for public participation. The article outlines the main achievements, limits and obstacles that have affected the environmental and health agendas in the last 30 years since the creation of the Unified Health System . The achievements are framed within the broadening of political space for public participation and the institutionalization of the theme of environmental risks within the SUS, while the limits are framed in the relationship between development and trends of environmental risk at global/regional, local and community scale. Finally, obstacles are outlined showing that the parliamentary coup of 2016 not only accentuated existing limits, but also represents a giant represent a giant step backward in various areas related to environmental health.

The scope of this study was to establish the incidence of sexual violence against children and adolescents in Recife, State of Pernambuco (Brazil) between 2012 and 2013. Data was collected from the records of rape examination reports carried out at the Recife Institute of Forensic Medicine. Of the 867 cases recorded, 328 of the victims were children and adolescents. An incidence of 3.67 cases per 10,000 inhabitants in the 0 to 18 age range was identified. The majority of the victims were female (92.1%) between 10 and 14 years of age (59.2%). In two thirds of the cases, rape was the most frequent type of sexual abuse and the majority of perpetrators were known to the victim (57.8%). An association between the type of sexual violence and the age and sex of the victim and perpetrator (p < 0.001) was determined. The most common type of sexual violence was rape among adolescents and sexual abuse not involving rape among children. The cases of sexual violence against children and adolescents shown in this study increase the visibility of this serious health problem and the need for preventive public policies.

Introduction: Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders., Methods: Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results., Results: In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive., Conclusions: Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.

Background: Hematopoietic stem cell transplantation is a curative treatment for many patients with hematological disorders. Donor-recipient genetic disparity, especially involving the human leukocyte antigen system is a critical factor for transplant outcome., Objective: To evaluate retrospectively donor characteristics and correlations with the occurrence of acute and chronic graft-versus-host disease, disease-free survival and overall survival in a Brazilian population submitted to allogeneic hematopoietic stem cell transplantation between 1994 and 2012 in a single center., Results: Three hundred and forty-seven consecutive transplantations were included. Related transplants (81.2%) were significantly more common than unrelated transplants (18.7%); donor and recipient median ages were 34 (range: 1-61) and 33 (range: 3-65) years respectively with donor HLAs being matched for 333 (95.9%) patients. Donor gender, cytomegalovirus status and ABO incompatibility did not influence the five-year overall survival. In univariate analyses, overall survival was negatively influenced by the presence of acute graft-versus-host disease (33% vs. 47%, respectively; p -value = 0.04), unrelated transplant (41.5% vs. 50.9%, respectively; p -value = 0.045) and donors aged over 40 years (41% vs. 52%, respectively; p -value = 0.03). Older donors were associated with a higher rate of acute (52% vs. 65.8%; p -value = 0.03) and chronic graft-versus-host disease (60% vs. 43%, respectively; p -value = 0.015). In multivariate analyses, acute graft-versus-host disease [relative risk (RR): 1.8; 95% confidence interval (CI): 1.1-29; p -value = 0.008] and older donors (RR: 1.6; 95% CI 1.11-2.24; p -value = 0.013) were associated with higher transplant-related mortality., Conclusions: In transplant patients, to have a donor older than 40 years of age seems to significantly increase the incidence of acute and chronic graft-versus-host disease and transplant-related mortality with no impact on disease-free survival and overall survival. In spite of the rather small cohort of patients, these findings are similar to what is described in the literature suggesting that a younger donor should be chosen whenever possible.

The aim of this study was to investigate the occurrence of Cryptosporidium in cattle and sheep from the North Pioneer mesoregion of the state of Paraná. For this, 317 stool samples were collected from cattle and sheep on 16 properties in six municipalities in the North Pioneer mesoregion of Paraná. For detection of Cryptosporidium species, molecular analysis was performed using nested-PCR techniques targeting the 18S rRNA gene. Of the 37 beef cows and 115 calves analyzed, four (10.8%) and 14 (12.2%), respectively, were positive for Cryptosporidium. Of the 12 cows and 52 calves, one (8.3%) and 14 (26.9%), respectively, were positive for Cryptosporidium; and of the 42 ewes and 59 lambs, six (14.3%) and 12 (20.3%), respectively were positive for Cryptosporidium. Cattle (15.3%) and sheep (17.8%) were both susceptible to infection. All the properties of the municipalities of Assaí, Ibaiti and, Leópolis presented infected animals. The study showed that Cryptosporidium occurs in most municipalities assessed, that dairy calves had a higher risk (Odds Ratio=2,66, p-value=0,018) for infection than beef calves, and that sheep are just as susceptible to infection as are cattle, and that further Cryptosporidium studies are developed.

Hansen's disease is probably the human disease that causes more damage. The aim of this study was to investigate the association between the occurrence of the association of grade 1 and 2 physical disabilities in Hansen's disease, as well as implications of joint analysis and strength of association with independent demographic and clinical variables. This is a quantitative, descriptive, retrospective, population-based and documentary study developed from 2009 to 2014 in a Hansen's disease reference center in Joao Pessoa, PB. It involved 414 medical records, the diagnosis and discharge data on socio-demographic, clinical and simplified neurological evaluation variables. Data were analyzed using descriptive (absolute frequency and percentage) and inferential (Chi-Square and Prevalence Ratio (PR) statistics techniques. Both in the diagnosis and discharge, low education level, multibacillary classification and presence of affected nerves were statistically associated to the development of disabilities (p <0.05). The gender showed association only at discharge (p <0.05). Male gender, low education level, multibacillary classification and presence of affected nerves were identified as factors associated with the development of disabilities, and the individuals were more likely to develop disabilities at discharge. There is a need for development of surveillance actions for the population group identified for the detection and early treatment of the disease. Higher chances of developing disabilities in the discharge period makes the promotion of guidelines that standardize the care of these individuals imperative.